Transplant Hospitals

[Guest guest]

Hello Kay--Is it possable to talk to you by phone?? If i pay for the

conversation?I am Mitch Bouyer--and I live in Brisbane Cal--and my freind

FredCofresi is about to do his last series of test that decides if he will be

a candidate for a liver.He asked me to be his support team for 90 days--my

answer determines if he goes to Alabama or stay's in Cal at UCLA.I am on the

web looking at netting with persons that can help us get the best info and

try to make the best choice possable--due to the fragile nature of this

need.I can communicate better by phone than keyboard. My freind is an AB

Positive type and i ask the AOC in Alabama about the probably of a liver

there in their coverage area and was emailed back that there had at one time

been more AB donors than receipients!! that causes a lot of concern about

where to go--and if the donor liver can be flown to another location (or the

patient) --so as to not loose that liver---due to no reciepient in the

coverage area.I'm not 100% UP TO SPEED about decifering current info or for

that matter---not sure of the intricate manner that the liver program is

being run etc. So because of the need and the humane involvment in all

concerned donors and reciepients---i am to help my freind decide--where, so

when he has to choose--he will have made the best choise.If you will mail me

back an answer--i would like to ask his wife if we can do a 3 way

conversation that we will pay for and do it at your convenience.That was an

interesting mail i read about this new report and i wonder if we are able to

communicate with those --that can help--to not loose a chance at a liver

--just because they are not able to find a reciepient local to the liver on

hand at the moment it is available.I'm sure that red tape will get in the

way--when gov. is involved.But we need to share and i hope you will be open

enough to mail me your responce. God bless you as you decide to do whats best

for all concerned.Mitch

[Guest guest]

Wanted to share this with the group

Report Finds Wide Disparities Among Transplant Hospitals

October 13, 1999

WASHINGTON (AP) - Offering a wealth of new data for transplant patients,

a government report documents striking differences among hospitals in the

likelihood patients will die while waiting a new heart or liver.

It's the first study to examine survival rates of all patients who enter

transplant waiting lists, offering a head-to-head comparison of 106 liver and

128 heart transplant centers.

" If you're a patient, your chances of survival depend enormously on

where you get your transplant, " said Rep. Henry Waxman, D-Calif., who requested

the data from the Department of Health and Human Services.

At the University of Kansas Medical Center, 89 percent of people

awaiting liver transplants got them within a year. But in Baltimore, just 21

percent of patients at the University of land and 23 percent at s

Hopkins Hospital got them in a year.

There were some disparities even among transplant centers in the same

cities, though these differences were generally less pronounced than regional

variances. In Boston, for instance, about 18 percent of liver patients at

Massachusetts General Hospital and 17 percent of patients at the New England

Medical Center died while waiting. But it was 33 percent at Beth Israel

Deaconess Medical Center, also in Boston, the report found.

Officials cautioned that patients must consider many factors when

choosing a transplant center.

" It should prompt questions rather than conclusions, " said

Gardett, a spokesman for the Department of Health and Human Services.

Still, Gardett said, the report may be useful to many people. " This

answers the questions a transplant patient would have: Will I get a transplant?

Will I be alive a year from now? " he said.

Several factors explain the national variation, experts say. They

include policies for distributing scarce organs, a community's willingness to

donate and the effectiveness of the local organ bank in collecting organs. They

also include a transplant surgeon's medical skills - both in keeping patients

alive while awaiting organs and in operating on and treating those who get

transplants.

The report was being released today, just as legislation remaking the

nation's transplant policies was expected to pass the House Commerce Committee.

That bill, strongly opposed by the Clinton administration, would severely

curtail the administration's power over the transplant network. It also would

allow the network to keep data like that in the new study secret from everyone

but transplant patients.

The report, which examined only livers and hearts, looked at patient

chances in three distinct ways, adjusting for the severity of each transplant

center's particular patients:

-Chance of getting a transplant, which relates primarily to policy

questions but also involves doctors' medical judgment about which organs to

accept.

On this score, patients at liver centers in the bottom 10 percent got

transplants just 24.9 percent of the time. Among the top 10 percent, it was 71.2

percent. For heart transplant programs, 35.8 percent got transplants at the

bottom compared with 71.8 percent at the top.

-Chance of dying while waiting for a transplant, which involves the

speed in which organs are procured and the ability to stay alive during the

wait.

In the lowest-scoring liver programs, 22.3 percent of patients died

versus 7.7 percent at the top programs. For heart transplant centers, 23.1

percent of patients at the bottom centers died, compared with 9.4 percent at the

top programs.

-Chance of surviving a year after coming on the list, whether the

patient gets a transplant or not. This involves a surgeon and a center's skill

at transplantation and postoperative care, along with the ability to keep

patients alive while waiting.

At the lowest liver programs, 65.3 percent of patients survived a year,

compared with 85.9 percent at the top. At the lowest heart programs, 67 percent

of patients survived a year, versus 84 percent at the top.

Beyond the variation at the top and the bottom, mixed results were

recorded in the middle as well, noted the report's author, Dr. Henry Krakauer.

Normally, statisticians expect a few low performers and a few high performers,

with most clustered in the center. But this report found that on several

measures, hospitals were all over the board.

" The range of probabilities is in all cases substantial, but the breadth

of the distribution of the transplant rates, especially in the case of the liver

.... is striking, " the report concluded.

The report includes data through early this year that cover all patients

who came onto the transplant waiting list between April 1994 through the end of

1997. It was reviewed by experts in the field, including officials from the

United Network for Organ Sharing, which collects the wealth of raw data from

transplant centers.

" You need to use this with a combination of a whole host of

information, " cautioned network spokesman Bob Speilbruner.

The network also produces data on patient survival, but only among those

patients who receive transplants. This is the first report to factor in a

patient's chances of getting an organ in the first place.